Difficulties in the revaccination program of hematopoietic stem cell transplantation recipients

Abstract

Hematopoietic stem cell transplant (HSCT) recipients should be routinely revaccinated after transplantation. We evaluated the difficulties met in the revaccination program and how a prospective and tailored follow-up could help to overcome these obstacles. HSCT recipients (n=122) were prospectively followed up and categorized into Group 1 (n=72), recipients who had already started the revaccination program, and Group 2 (n=50), recipients starting their vaccines. Whenever a difficulty was reported, interventions and subsequent evaluations were performed. Reported problems were related to patient compliance, HSCT center and/or vaccination center. Problems related to patient compliance were less frequent than those related to HSCT center modifications of previous recommendations, or to errors made by the vaccination center. The main gap found was vaccination delays (81.9%). Advisory intervention was needed in 64% and 46% of Group 1 and Group 2, respectively (p=0.05), and was partially successful in around 70% of the cases. Total resolution was achieved in more than 35% in both groups. Improvements are needed in the Brazilian vaccination program for HSCT recipients to assure a complete and updated revaccination schedule. HSCT centers should assign nurses and transplant infectious disease specialist physicians to organize the revaccination schedule and to monitor the program development.

Quality improvement initiative to improve revaccination rates after autologous stem cell transplantation

“…In other institutions, increased efforts to educate patients and tailored follow ups have been identified as solutions to improve revaccination programmes. 5 In another study examining reasons for declined revaccinations, some cited reasons included time out from transplant, immunosuppressive therapy and prior adverse reactions. 6 …”

“…This study suggests that mailing personalised information packets on how to access and fund vaccinations may be an effective low-cost strategy to improve post-ASCT revaccination compliance. In other institutions, increased efforts to educate patients and tailored follow ups have been identified as solutions to improve revaccination programmes 5. In another study examining reasons for declined revaccinations, some cited reasons included time out from transplant, immunosuppressive therapy and prior adverse reactions 6…”

Revaccination Program Post-Hematopoietic Stem Cell Transplantation and COVID-19 Vaccine: Current Challenges

“…istration and application of the vaccines, in private clinics, CRIE, basic health units (UBS) or vaccination rooms (15) .…”

“…According to a national study, delays in the revaccination program were observed in about 80% of the participants, the majority due to failures by the transplant center in referring the patient for vaccination or in the application of vaccines in the vaccination sites. The lack of compliance by the patient or guardian was observed in a small frequency (15). Therefore, it is clear that efforts to ensure the success of the revaccination program must focus mainly on educational activities at HSCT centers and on greater integration of HSCT centers with CRIE and vaccination sites.…”

Resposta vacinal em pacientes submetidos a transplante de células-tronco hematopoiéticas no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto

“…Existem recomendações para a vacinação após o transplante no nosso país (MINISTÉRIO DA SAÚDE, 2019;GARNICA et al, 2010;MACHADO, 2021), porém poucos estudos foram realizados para avaliar a implementação da vacinação (SILVA et al, 2017) e o que diz a respeito à resposta vacinal (MACHADO, 2004;MACHADO et al, 2002;ADATI et al, 2020).…”